0265

RELATION OF SERUM LDHi TO CT NUMERICAL VALUE IN NEWBORNS WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY

NA Q, WANG H, WU P.

Maternal and Child Health Hospital, Fengtai District, Beijing, China

Objective：To observe the relationship between the early change of serum lactate dehydrogenase isozymes (LDHi) and brain CT changes in newborns with hypoxic ischemic encephalopathy (HIE), thereby to make early and objective assessment of the brain damage and prognosis.

Methods：Serum LDHi level was determined by using a modified agar-gel-eletrophoresis in 51 newborn infants with HIE and 15 normal newborns within 24 hours after they were born. Within 4-7 days after birth, the severity (mild, moderate, severe) of HIE was determined through coronal CT for the HIE cases；5-10 low density foci were chosen for each HIE case and 5-10 random sites of brain lobes were chosen for each normal newborn infant and the mean values were calculated.

Results：Compared with the normal group, LDH1 level in HIE group declined with the deteriation of HIE, while LDH5 increased and the ratio of LDH5/LDH1 elevated significantly (p<0.01); CT numerical value also significantly declined with the deteriation of HIE (p<0.01). The average ratio of LDH5/LDH1of the 3 cases who died of serious HIE was as high as 2.2 (3 times that of control group), the CT numerical value decreased to 6.85 Hu (3-fold decrease as compared to the control values).

Conclusion：The ratio of LDH5/LDH1 could sensitively and early determine degree of brain damage. The changes of CT numerical value within 4-7 days after birth, combined with the ratio, may predict more objectively the severity of brain damage and prognosis of newborns with HIE. Our results suggest that LDH5/LDH1 >2.0, CT numerical value <7 Hu indicate unfavorable prognosis.